What is Testicular Cancer?

Written by Medicover Team and Medically Reviewed by Dr Ramavath Dev , Oncologists

Testicular cancer is a type of cancer that develops in the testicles (testes), which are part of the male reproductive system. These glands are located inside the scrotum, the loose bag of skin underneath the penis, and are responsible for producing sperm and the hormone testosterone.

Most testicular cancers originate in the germ cells, which are the cells responsible for producing sperm. The two main types of testicular germ cell tumors are seminomas and non-seminomas, which grow and spread differently.

Testicular cancer is relatively rare but is the most common cancer in males aged 15 to 35. It is highly treatable, especially when detected early. Common signs include a painless lump or swelling in the testicle, a feeling of heaviness in the scrotum, or discomfort in the lower abdomen or groin.

Early diagnosis and prompt treatment, typically involving surgery, radiation, or chemotherapy, offer excellent chances of cure in most cases.

What are the Different Types of Testicular Cancer?

Testicular cancer is primarily classified based on the type of cells in which it begins. The majority of testicular cancers originate from germ cells, but other rare forms can arise from different testicular tissues. Here are the main types:

Germ Cell Tumors (GCTs)

These account for about 95% of all testicular cancers and are divided into two main subtypes:

Seminomas

Grow slowly and are generally more responsive to radiation therapy.
Usually occurs in men between the ages of 25 and 45.
This can be further classified into:

Classical seminomas (most common)
Spermatocytic seminomas (rare and occur in older men)

Non-Seminomas

Tend to grow and spread more quickly than seminomas.
Usually occurs in younger men, often in their late teens to early 30s.
Include several subtypes:

Embryonal carcinoma
Yolk sac tumour
Choriocarcinoma
Teratoma (can be mature or immature)

Some tumors may be mixed germ cell tumors containing both seminoma and non-seminoma components.

Stromal Tumors (Non-Germ Cell Tumors)

These are rare and develop from the hormone-producing or supportive tissues of the testicles.

Leydig Cell Tumors:

It may produce testosterone or estrogen.
It can cause hormonal symptoms like breast tenderness or early puberty.

Sertoli Cell Tumors: Usually benign, but in rare cases, they may become malignant.

Secondary Testicular Tumors

These are cancers that spread (metastasize) to the testicles from other parts of the body (e.g., lymphoma or prostate cancer in older men).
They are not true testicular cancers, but they can involve the testes.

What Are the Stages of Testicular Cancer?

Diagnosing testicular cancer involves not just detecting the presence of cancer, but also determining its stage, a crucial step that guides treatment decisions and helps predict outcomes. Staging is based on how far the cancer has spread, whether tumor markers are elevated, and the involvement of nearby tissues or distant organs.

Stage 0: Germ Cell Neoplasia in Situ (GCNIS)

Abnormal cells are found inside the testicle but have not yet spread.
This stage is considered precancerous.
Often discovered incidentally and may not cause symptoms.
May require close monitoring or surgery if progression risk is high.

Stage I: Localized Cancer

Cancer is confined to the testicle.
It may involve nearby blood or lymphatic vessels within the testis.
Tumor markers like AFP, HCG, or LDH may be normal or slightly elevated.
Usually treated with surgery, and sometimes chemotherapy or surveillance.

Stage II: Regional Spread to Lymph Nodes

Cancer has spread to lymph nodes in the back of the abdomen (retroperitoneal lymph nodes), but not beyond.
Tumor markers may still be within normal limits or mildly elevated.
Treatment may involve surgery and/or chemotherapy depending on the extent of spread.

Stage III: Distant Spread (Advanced Cancer)

Cancer has spread beyond the retroperitoneal lymph nodes to:

Distant lymph nodes (e.g., neck or chest)
Or other organs like the lungs, liver, or brain.

Tumor markers are moderately to highly elevated.
Requires a more aggressive treatment approach, including combination chemotherapy, and possibly additional surgery.

What are the Testicular Cancer Symptoms and Warning Signs?

Testicular cancer often presents with noticeable yet sometimes painless changes in the testicles. Recognising symptoms early can significantly improve the chances of a successful treatment outcome. Common signs include:

Primary Symptoms

Painless lump or swelling in either testicle (most common early sign)
Feeling of heaviness in the scrotum
Change in size or shape of a testicle (enlargement or shrinkage)
Dull ache or discomfort in the lower abdomen or groin
Sudden buildup of fluid in the scrotum

Additional Warning Signs

Pain or discomfort in a testicle or the scrotum
Breast tenderness or enlargement (gynecomastia) due to hormone changes
Back pain, mainly if the cancer has spread to lymph nodes
Shortness of breath, chest pain, or cough if the cancer spreads to the lungs

What are the Common Causes and Risk Factors of Testicular Cancer?

The exact cause of testicular cancer is not always known, but several risk factors are known to increase a man's chances of developing the disease. Understanding these can help in early detection and prevention strategies.

Common Causes

Testicular cancer typically develops when healthy cells in a testicle mutate and grow uncontrollably. Most cases originate in germ cells, which produce sperm. The exact trigger for this mutation is unclear; however, both genetic and environmental factors may contribute to its development.

Major Risk Factors

Undescended Testicle (Cryptorchidism): Males whose testicles did not descend into the scrotum before birth are at significantly higher risk, even if surgery was done to correct it.
Family History: Having a close relative (father or brother) with testicular cancer increases the risk.
Personal History: Men who have had cancer in one testicle are at higher risk of developing it in the other testicle.
Age: Most common in males between the ages of 15 and 35, but it can occur at any age.
Race and Ethnicity: More common in White men compared to men of African or Asian descent.
Abnormal Testicle Development: Conditions such as Klinefelter syndrome and other disorders that affect testicular development may increase the risk.
Infertility: Some studies suggest a link between male infertility and a higher risk of testicular cancer.
HIV Infection: Men with HIV, particularly those with AIDS, may have an increased risk.

Less Established or Possible Risk Factors

Exposure to certain environmental chemicals (e.g., endocrine disruptors)
Smoking
Testicular trauma (not proven but sometimes considered in individual cases)

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How is Testicular Cancer Diagnosed?

Early diagnosis of testicular cancer plays a crucial role in effective treatment and better outcomes. If a man notices any abnormalities, such as a lump or discomfort in the scrotum, a prompt medical evaluation is essential.

Doctors use a combination of physical exams, imaging tests, and lab investigations to confirm the diagnosis.

Common Diagnostic Tests for Testicular Cancer

Physical Examination: The doctor will examine the testicles for any lumps, swelling, or changes in their size and consistency.
Scrotal Ultrasound: A high-resolution ultrasound helps differentiate between solid tumours and benign cysts. It is a non-invasive and accurate test for detecting masses in the testicle.
Blood Tests for Tumor Markers: Specific proteins, known as tumour markers, may be elevated in testicular cancer. These include:

Alpha-fetoprotein (AFP)
Human chorionic gonadotropin (HCG)
Lactate dehydrogenase (LDH)

Imaging Tests (CT Scan or MRI): Used to determine if cancer has spread beyond the testicles, especially to the lymph nodes, lungs, or abdomen.
Radical Inguinal Orchiectomy (Surgical Biopsy): Unlike many other cancers, a biopsy of the testicle is not done via a needle. Instead, if cancer is suspected, the entire testicle is surgically removed through the groin for examination. This helps prevent the spread of tumour cells and provides a definitive diagnosis.

Other Tests May Include

Chest X-ray or PET Scan to check for metastasis to the lungs or other organs.
Genetic or Chromosomal Testing is in rare cases, especially if a hereditary cancer syndrome is suspected.

What are the Treatment Options for Testicular Cancer?

Testicular cancer is one of the most treatable cancers, especially when detected early. Treatment depends on the type of cancer (seminoma or non-seminoma), its stage, and the patient's overall health.

A multidisciplinary approach involving urologists, oncologists, and radiation specialists ensures personalized and effective care.

Primary Treatment Modalities

Surgery

Radical Inguinal Orchiectomy: The primary treatment for almost all cases involves the removal of the affected testicle through an incision in the groin.

Recovery Time: 1-2 weeks for everyday activities, 4-6 weeks for strenuous exercise.

Retroperitoneal Lymph Node Dissection (RPLND): This may be recommended in non-seminoma cases if lymph nodes are involved. This is a more complex procedure done via open or laparoscopic surgery.

Chemotherapy

Commonly used in advanced-stage or metastatic testicular cancer.
Drugs such as bleomycin, etoposide, and cisplatin (BEP regimen) are highly effective.
Treatment Duration: Typically 3-4 cycles over 9-12 weeks.
Side Effects: Nausea, fatigue, and hair loss, but most are temporary and manageable.

Radiation Therapy

Primarily used in seminoma-type tumours, which are more sensitive to radiation.
Focuses on lymph nodes in the abdominal area.
Duration: Usually 2-3 weeks of daily sessions.
Recovery: Minimal downtime; mild fatigue and skin irritation may occur.

Surveillance

For very early-stage cancers, close follow-up may be an option post-surgery.
Includes regular blood tests, imaging, and physical exams.
Helps avoid overtreatment while still catching any recurrence early.

When to See a Doctor for Testicular Cancer?

Early evaluation is crucial when it comes to testicular cancer. Many men delay medical consultation because the symptoms are painless or seem minor. However, identifying the warning signs and acting promptly can make a significant difference in treatment success and recovery.

You Should See a Doctor If You Notice

A painless lump or swelling in either testicle that persists for more than two weeks
A sudden change in the size or firmness of a testicle
Dull ache or discomfort in the lower abdomen, groin, or scrotum
A feeling of heaviness in the scrotum
Sudden buildup of fluid in the scrotum
Persistent pain or tenderness in one testicle

High-Risk Groups Should Be Especially Vigilant

Men with a history of undescended testicles (cryptorchidism)
Those with a family history of testicular cancer
Individuals with previous testicular cancer in one testicle
Men aged 15 to 35, the age group at highest risk

If you belong to any of these risk categories and notice even minor changes in your testicles, consult a urologist without delay.

Timely medical attention saves lives. Most cases of testicular cancer, when diagnosed early, are highly treatable and curable. Don't ignore warning signs; early consultation is key to preserving both health and fertility.

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What is the Recovery Process After Testicular Cancer Treatment?

Recovery from testicular cancer is generally positive, especially when detected early and treated effectively. However, healing doesn't stop after surgery or chemotherapy, it's a gradual process that includes medical follow-ups, lifestyle adjustments, and emotional support.

Follow-Up Schedule

Regular monitoring helps ensure there's no recurrence:

Every 3-6 months for the first 2 years: Includes physical exams, tumour marker blood tests (AFP, HCG, LDH), and imaging (CT scans, X-rays).
Annually, after 2 years, based on your stage and treatment type.
Long-term surveillance may continue for up to 10 years in some cases.

Lifestyle and Diet Recommendations

Nutrition: A balanced diet rich in antioxidants (fruits, vegetables, whole grains) supports recovery and strengthens immunity.
Physical activity: Engaging in light to moderate exercise helps rebuild strength and improve mood.
Avoid tobacco and alcohol, as they can impact healing and increase cancer risks.
Fertility planning: Discuss sperm banking before treatment and explore fertility options if needed after recovery.

Most men treated for testicular cancer live long, healthy lives. The five-year survival rate exceeds 95%, even for patients with advanced stages. Many return to regular work, relationships, and physical activity within a few months of treatment.

What Precautions Can Help Prevent Testicular Cancer?

While there's no guaranteed way to prevent testicular cancer, certain practices may help in early detection and risk reduction.

Prevention Tips

Regular Testicular Self-Exams (TSE): Monthly self-checks help detect lumps or changes early.
Early correction of undescended testicles: If not corrected in childhood, it increases risk.
Healthy lifestyle choices:

Maintain a balanced diet and healthy weight.
Avoid exposure to endocrine-disrupting chemicals.
Refrain from smoking

Awareness and Education: Understanding one's family history and risk factors enables proactive health management.

Complications if Left Untreated

Cancer Spread (Metastasis): Testicular cancer can quickly spread to lymph nodes, lungs, liver, and brain if not treated.
Infertility: Advanced or untreated cancer may impair fertility.
Hormonal Imbalance: Loss of testosterone production may occur if both testicles are affected.

Prompt treatment helps avoid serious complications and ensures a better quality of life.

Our Experience Treating Testicular Cancer at Medicover Hospitals

At Medicover Hospitals, we understand that a testicular cancer diagnosis can be overwhelming. Our team of expert urologists, oncologists, and fertility specialists delivers evidence-based, compassionate care focused on healing both body and mind.

From advanced diagnostic imaging to minimally invasive surgeries and personalized chemotherapy plans, we ensure every patient receives the highest standard of care. Our multidisciplinary tumour board thoroughly discusses each case to tailor the most effective treatment.

More importantly, we walk the journey with you, offering continuous support through:

Post-treatment recovery and fertility care
Psychological counselling
Dedicated helplines and follow-up assistance

You are not alone at Medicover; your recovery is our commitment.